Active NPI
Mackenzie Blackburn
- Pediatrics Physician
- Albuquerque, NM
National Provider Identifier
1235748211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 58.035028
- Practice address
- 8500 Washington St NE Ste A1
Albuquerque, NM 87113-1861 - Phone
- (505) 828-3837
- NPI assigned
- Jul 27, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 58.035028 | OH | Primary |
Addresses
Primary practice location
8500 Washington St NE Ste A1
Albuquerque, NM 87113-1861
Mailing address
700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-4419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250728000166 | OH | Order and Referring Only - Pediatric Medicine | 4486161247 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58.035028 | OH | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752537600000",
"number": "1235748211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 CHILDRENS DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432052664",
"telephone_number": "614-722-4419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8500 WASHINGTON ST NE STE A1",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871131861",
"telephone_number": "505-828-3837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKBURN",
"first_name": "MACKENZIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-27",
"last_updated": "2025-07-15",
"certification_date": "2025-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "58.035028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.